A Rare Strain Actinomadura geliboluensis Was First Isolated from the Bronchoalveolar Lavage Fluid of a Patient with Pneumonia.

Background: Actinomadura geliboluensis was first isolated in 2012 in Gelibolu, Canakkale, Turkey, and has not been reported to be isolated from humans until now. We have isolated it from the bronchoalveolar lavage fluid (BLF) of a patient with pneumonia and found its drug resistance. It is the first time that Actinomadura geliboluensis has been isolated from humans since its discovery and naming. This case may provide new ideas and methods for the clinical diagnosis and treatment of pulmonary actinomycosis. Case Description: The patient was a 75-year-old male who was hospitalized in a township hospital and failed to improve after penicillin treatment. After admission to our hospital, the patient was treated with piperacillin/tazobactam according to clinical guidelines for 14 days. Actinomadura geliboluensis was isolated from the patient's BLF and was identified by 16S rRNA sequencing. This report shows the biological characteristics and in vitro drug susceptibility testing, as well as the genomics analysis based on next-generation sequencing (NGS). The results demonstrated that Actinomadura geliboluensis was easy to be mistakenly identified as Actinomyces dental caries by using the Merieux ANC identification card. Based on the MIC test, Actinomadura geliboluensis was susceptible to tetracyclines, quinolones and sulfonamides, but resistant to carbapenems, penicillins and cephalosporins. The K-B test results showed Actinomadura geliboluensis was highly sensitive to piperacillin/tazobactam. Genomic analysis based on NGS showed that the Actinomadura geliboluensis belongs to Planobispora rosea EF-Tu mutants conferring resistance to inhibitor GE2270A, AAC(3)-VIIa, vanRO, chrB, and mexY. Conclusion: Actinomycetes is generally sensitive to Penicillin but Actinomadura geliboluensis is not. In vitro drug susceptibility test is needed to support individualized drug use to avoid delay in the disease.

Magnetic Resonance Imaging combined with Computed Tomography in the Diagnosis of Multiple Myeloma and the Killing Effect of Doxorubicin Nano-drug Delivery System on Myeloma Cells.

It was to adopt magnetic resonance imaging (MRI) combined with computed tomography (CT) to diagnose multiple myeloma (MM) and evaluate the therapeutic effect of the doxorubicin nano-drug delivery system on MM, providing a more effective method for the treatment of MM. For this aim, eighty-eight patients with MM admitted to our Hospital from June 2019 to July 2020.7 were selected as study subjects and divided into a control group (treated with doxorubicin) and an observation group (treated with doxorubicin-loaded nanoparticles) according to the random number table, 44 cases for each group. MRI and CT were used to examine the two groups of patients to assess the clinical efficacy and side effects of the two treatments and to compare the myeloma cell survival rate and apoptosis rate. Results showed that the diameter of nanoparticles was about 50 nm, the particle size was uniform, the distribution was dense, and the stability was good; the lesion was well-circumscribed on CT scan, and a soft tissue mass could be detected on MRI. The number of patients with effective treatment in the observation group was significantly higher than that in the control group (42 cases vs 34 cases) (P< 0.05); the number of patients with small plate reduction, increased myocardial enzymes, alopecia, liver failure, gastrointestinal reactions, peripheral neuritis, and other adverse reactions in the observation group was significantly lower than that in the control group (total number of patients 48 vs 101) (P< 0.05); the survival rate of myeloma cells in the observation group was obviously inferior to that in the control group (61.3 % vs 88.31 %) (P< 0.05). Conclusion: MRI combined with CT examination can be better used for the diagnosis of the disease, and the study shows that doxorubicin nano-drug delivery preparation is safer and more effective in the treatment of MM disease, which is worthy of clinical promotion.

Resection of giant malignant solitary fibrous pleural tumor after interventional embolization: a case report and literature review.

BACKGROUND: Solitary fibrous tumor of the pleura (SFTP) is a rare mesenchymal tumor that arises at various sites and typically originates from the pleura. Most patients with SFTPs are asymptomatic, unless the tumor is large. Approximately 20% of SFTP cases are malignant. There are few reports on imaging diagnoses and interventional treatments of SFTP. Here, we report a case of a giant SFTP that exhibited malignant behavior and underwent successful resection after embolization of the main supply artery of the tumor. CASE PRESENTATION: We report a clinical case of a giant SFTP in a 66-year-old Chinese female patient complaining of chest tightness and cough for more than 2 months. Ten years ago, the patient had undergone a chest CT scan at a local hospital for cough. Computed tomography (CT) had revealed a mass in the right thoracic region, which was misdiagnosed as a pulmonary abscess by CT-guided biopsy. Therefore, the patient did not receive appropriate/complete treatment at that time. She was hospitalized again, because CT showed significant enlargement of the right thoracic mass, which caused her obvious symptoms of discomfort. The pathological results of CT-guided biopsy at our hospital confirmed SFTP. Considering the large size of the tumor and the rich blood supply, some of the main blood vessels were treated with embolization before surgical resection. A large tumor, about 23 cm × 16 cm × 15 cm in size, was then successfully removed by thoracic surgery. The diagnosis of malignant SFTP was confirmed by surgical pathology and immunohistochemistry. CONCLUSION: Imaging findings of SFTPs are not characteristic, especially when a tumor is large, the diagnosis is difficult, and the final diagnosis still depends on histological and immunohistochemical examinations. The two-stage surgical treatment described here, which involves first embolization of the main supplying artery of the large tumor and then complete surgical resection, is effective and safe for SFTPs. Whether needle biopsy or vascular embolization is performed, intervention plays a crucial role in the diagnosis and treatment of patients with SFTPs.